Page 4 - Cover Letter and Evaluation for Frank Levy

CSG Actuarial’s premiums can be helpful in a couple of ways. First, they can serve as a starting
point to identify the companies that have lower premiums, and then you can contact those
companies for current quotes; second, the quotes from CSG Actuarial also show the insurance
companies’ financial ratings by A.M Best and (for the larger companies) Standard & Poor. They
do not show the companies’ phone numbers, which can be found in Appendix B3.

Some companies offer discounts of various kinds. As an example, a few companies will offer
small discounts for annual pre-payment of premiums or for automated monthly payments
debited to your bank account. Also, some companies offer “household discounts” ranging
between 3% and 10% when both spouses buy a policy. And the UnitedHealthcare Medigap
policies endorsed by AARP offer a 3% a year discount for each year that the policyholder is
younger than 75 (in your case, that’s a 12% discount).

Medicare Advantage plans

Advantage plans are managed-care plans – primarily HMO’s and PPO’s. Before enrolling in an
Advantage plan, you should verify with the providers that you want to see that they are in the
plan’s network (occasionally the online directories that we use are out of date).

Because there are several Aetna and Humana Advantage plans that share similar or even
identical names although their benefits are different, if you enroll in one of these plans you
should use the Plan’s ID number, shown on pages 2-3 and in the appendices, to make sure that
you are enrolling in the right plan.

Here are summaries of the two Advantage plans compared in your evaluation.

1) Aetna Medicare Choice PPO Plan (H5521-060-0). Dr. Basit is listed in this plan’s network
directory but Dr. Aderinto is not, as shown in Appendix A. But according to the
Memorial Hermann website, Dr. Aderinto does accept Aetna Medicare plans (also
shown in Appendix A). If she is not in the network, you would still be covered when you
see her but will pay 50% of cost for most Medicare-covered services.

Prior to enrolling in an Advantage plan, you should verify with your physicians’ offices
that they are still in the plan’s network (or if a physician in not listed in the network, you
can ask the office staff if he or she is in the network).

This plan has several good features – an above-average four-star quality rating from
Medicare, zero premiums for medical coverage, and no health plan deductible. Its
downside is that you will pay 50% of the cost for most out-of-network services unless
it’s an emergency.

2) Humana Choice PPO Plan (H5215-043-1). There are several Humana Choice Advantage
plans in your area, all of them with roughly similar benefits. I selected this plan for your
evaluation because it is the lowest-cost of any of the Humana PPO Advantage plan plan

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